Abstract
A cross-sectional survey was conducted in neonatal and maternity units of five Kenyan district public hospitals. Data for 1 year were obtained: 3999 maternal and 1836 neonatal records plus tallies of maternal deaths, deliveries and stillbirths. There were 40 maternal deaths [maternal mortality ratio: 276 per 100 000 live births, 95% confidence interval (CI): 197–376]. Fresh stillbirths ranged from 11 to 43 per 1000 births. A fifth (19%, 263 of 1384, 95% CI: 11–30%) of the admitted neonates died. Compared with normal birth weight, odds of death were significantly higher in all of the low birth weight (LBW, <2500 g) categories, with the highest odds for the extremely LBW (<1000 g) category (odds ratio: 59, 95% CI: 21–158, p < 0.01). The observed maternal mortality, stillbirths and neonatal mortality call for implementation of the continuum of care approach to intervention delivery with particular emphasis on LBW babies.
Highlights
Global reports indicate that the highest risk of neonatal death is in Sub-Saharan Africa, with Kenya among the 10 countries contributing most deaths [1]
Compared with normal birth weight, odds of death were significantly higher in all of the low birth weight (LBW,
Teenage (13–19 years) mothers accounted for 19% (745 of 3938, 95% confidence interval (CI): 12–26%) of these records
Summary
Global reports indicate that the highest risk of neonatal death is in Sub-Saharan Africa, with Kenya among the 10 countries contributing most deaths [1]. National, and global, reports are based on limited data on neonatal case-mix and outcomes; the available data are largely derived from episodic, limited-scale surveys [4]. The national hospital information management system (HMIS) in Kenya has been shown to have poorquality data [5]. There are few data exploring possible variability in neonatal case-mix.
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